China Creates Acupunctural Anaesthesia

RESPONDING to our great leader Chairman Mao's call "Chinese medicine and pharmacology are a great treasure-house; efforts should be made to explore them and raise them to a higher level," China's medical and scientific workers have created acupunctural anaesthesia — a unique Chinese anaesthetizing technique. They have achieved this by combining revolutionary zeal with a scientific approach, applying modern scientific knowledge and methods, and summing up and improving on the experience of traditional Chinese medicine in stopping pain and curing ailments with needling. Using acupuncture instead of anaesthetics to induce analgesia is a breakthrough in surgical anaesthetization. It is a tremendous contribution to the development of medical science and a brilliant example of how Chinese medical workers have firmly carried out Chairman Mao's instruction on combining Chinese with Western medicine and taking China's own road of developing medicine.

I

Administering acupunctural anaesthesia involves inserting one or more needles into certain points of a patient's limbs, ears, nose or face. Analgesia follows after a period of inducement and stimulation, thereby ensuring safe operations on the head, chest, abdomen or limbs. This new method is being used in many civilian and army hospitals and clinics in the cities and rural areas throughout the country. More than 400,000 patients have received acupunctural anaesthesia for surgical operations, including children and people in their eighties. The rate of success is around 90 per cent. Anaesthetization by acupuncture does not need complicated apparatus; it is applicable regardless of equipment, climate and geographical conditions. It can therefore be widely popularized in the cities and is particularly suitable to mountainous and rural areas and under war conditions. Patients are fully conscious during operations when this kind of anaesthetization is used. Apart from being dulled or insensitive to pain, they are normal in other physiological functions. During operations, therefore, they can give play to their subjective dynamic role, constantly strengthen their confidence in overcoming the diseases, and respond to the surgeons as the latter require, enabling speedy and successful operations. When an anaesthetic is administered for an operation to correct squinting, success or failure is known only after the effects of the drug wear off. But when anaesthetization is done by acupuncture, the patient's eyeballs can move normally so that the doctor can ascertain the result of the operation then and there. Applying acupunctural anaesthesia in thyroidectomy, the surgeon can freely talk to the patient to determine the condition of vocalization so as to avoid inadvertently damaging the nerves controlling the vocal functions. When performing a heart operation or pneumonectomy with this anaesthetization, the doctor can ask the patient to do abdominal breathing so as to facilitate the operation. In orthopedic operations, such as plastic surgery of finger muscles and tendons, it makes possible the patient's retaining the functions of his fingers and moving them as usual. This, coupled with the patient's active co-operation, helps the doctor find the injured muscles and tendons easily. And after the operation, the patient can immediately move his fingers to test the results. Anaesthetization by acupuncture helps prevent disorder in the patient's physiological functions during the operation and, after its completion, avoid harmful effects from the use of anaesthetics. Moreover, needling can set in motion and strengthen the patient's positive factors to resist diseases and can regulate the functions of organisms. As a result, the patient's blood pressure, pulse and breathing in general remain normal during the operation. Incisions heal and functions of the organisms concerned are restored quickly and satisfactorily after the operation, and consequently the patient can move about and take food early. In the case of patients who suffer from poor functioning of liver, kidneys or lungs, high blood pressure. debility from serious disease, shock or are over-sensitive to anaesthetics, anaesthetization by drugs is not advisable, while acupunctural anaesthesia ensures safe operations. Clinical practice has abundantly proved that this new method is safe, simple, economical and effective.

II

The working people of China began to cure ailments and diseases by needling several thousand years ago. From then to the introduction of acupunctural anaesthesia represents a leap in the history of acupuncture in China and adds new splendour to China's time-honoured medicine and pharmacology. The new method came into being and developed in the sharp struggle between the two lines. Its success is a great victory for Chairman Mao's proletarian line in health work and scientific research. Acting in accordance with Chairman Mao's teaching to carry forward and develop the legacy of Chinese medicine, doctors trained in Western medicine began to study and learn from traditional Chinese medicine in 1958. Combining Chinese and Western medicine, they began using Chinese medicines and drugs and acupuncture on a wide scale to cure diseases. In clinical practice, medical workers in the cities of Sian and Shanghai and in Shansi and Hopei Provinces and other places experimented on using acupunctural anaesthesia in operations, such as thyroidectomy and removing tonsils. Their initial success paved the way for subsequent extensive use. The throat of a patient in the No. 1 People's Hospital in Shanghai was so painful he could not swallow anything after he had his tonsils out. Medical personnel in the otolaryngology department inserted a needle at the hoku point and the pain stopped immediately. The patient then ate a bowl of meat dumplings without difficulty. This was an eye-opener for the medical workers who thought that if needling could stop the pain, it might also be used to replace anaesthetics in tonsil operations. Determined to open a new trail, they repeatedly inserted needles into the hoku and netting points to ascertain the degree of pain. When these experiments proved that needling in this way was very effective in stopping pain, they boldly applied it to actual operations. Later, the Liuchou Tuberculosis Hospital in Kwangsi and the No. 1 Tuberculosis Central Hospital in Shanghai and other hospitals also succeeded in using acupunctural anaesthesia for pneumonectomy, thereby creating experience for applying this method to major operations. "New things always have to experience difficulties and setbacks as they grow." No sooner had acupunctural anaesthesia appeared than it was suppressed by Liu Shao-chi's counterrevolutionary revisionist line and attacked by bourgeois "experts." In a vain attempt to nip it in the bud, they raved that it was "not scientific," "without any practical value" and a "retrogression" in the history of anaesthesia. Repeatedly studying Chairman Mao's teaching "We cannot just take the beaten track traversed by other countries in the development of technology and trail behind them at a snail's pace," the medical workers made up their minds to break new ground for anesthesiology. Disregarding ridicule and attacks, they persisted in accumulating experience through clinical practice and constantly raising the efficacy and widening the scope of applying acupunctural anaesthesia in operations. The Great Proletarian Cultural Revolution swept away the bourgeois trash and revolutionary medical workers relentlessly criticized Liu Shao-chi's counterrevolutionary revisionist line in health work and scientific research. This facilitated great development and improvement in acupunctural anaesthesia. Since the start of the Great Proletarian Cultural Revolution, more than 400,000 operations have been performed with acupunctural anaesthesia, as against less than 10,000 in the previous eight years. It is now used in nine out of ten hospitals in Shanghai that have surgical departments. Using this method, the Worker-Peasant-Soldier Hospital attached to the Shanghai No. 2 Medical College has considerably reduced the mortality rate after brain surgery, where 90 per cent of these operations are done with acupunctural anaesthesia. A few years ago, analgesia was induced only by needling the body and ears. Now this has been extended to the face and nose, following discoveries by medical personnel through practice, with needling done either by hand or electricity; in some cases analgesia is induced by injections of distilled water at certain points. Previously, a patient undergoing a pneumonectomy had to be needled at several dozen or even more than 100 points on his limbs and four medical workers had to attend to the work of manipulating the needles without let-up. During the Great Cultural Revolution, medical workers at the P.L.A. Kwangchow Units Central Hospital, the Peking Tuberculosis Research Institute, the No. 1 Tuberculosis Central Hospital in Shanghai and other hospitals conscientiously studied Chairman Mao's philosophical works to guide their practice. Boldly experimenting on themselves with needles to determine the degree of pain, they eliminated the unnecessary points and, by grasping the main contradiction and bringing into play the role of the main points, succeeded in reducing the number to a few and sometimes even to one. Thus, by needling only a few important points, the effects of anaesthesia was greatly improved. The Peking Tuberculosis Research Institute recently achieved complete success in using one needle to anaesthetize more than 90 patients undergoing thoracic operations. Acupunctural anaesthesia still has some imperfections. For instance, at certain stages in some operations, patients still feel some pain, and some feel uncomfortable as a result of visceral traction. Chinese medical and scientific workers are making still greater efforts in studying Marxism-Leninism-Mao Tsetung Thought and are using dialectical materialism to guide their medical work and scientific research. Daring in practice and in breaking new ground, they are bending their efforts to perfect acupunctural anaesthesia.

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A Small Needle Works Wonders

IN a spacious and brightly lit operating-room, medical workers of the Peking Worker-Peasant-Soldier Hospital and the Peking Tuberculosis Research Institute were performing a thoracoplasty on Hu Shu-hsuan, a patient suffering from pyothorax. There was no complicated anaesthetization apparatus, nor any odour of anaesthetics. The medical personnel simply used two needles which they inserted into Hu's auricles and twisted lightly for some 20 minutes. The operation then commenced, with the patient fully conscious. The patient's pyothorax was the result of infection after an operation five years earlier. Pus and blood oozed out through a fistula in his chest all the year round. An operation was required to clear out the pus and obliterate the cavity. However. Hu Shu-hsuan was weak, his heart and lungs functioned poorly and he obviously could not stand the effects of anaesthetics. On several previous occasions, general anaesthesia had caused cardiac failure which endangered his life. Later, spinal anaesthesia and local anaesthesia were applied instead. But these also failed to ease the pain and the operations proved unsatisfactory. Having undergone 24 unsuccessful minor and major operations in all, he had become weaker and weaker. In this latest operation with acupunctural anaesthesia, skin consisting almost entirely of scar tissues had to be cut; in addition, six ribs had to be cut, bones that had grown following each earlier operation removed and the pus and infected part in the cavity cleared out. The difficulties involved and the effects of the operation on the patient were far greater than before. But throughout the two-and-a-half-hour operation, the patient was calm and in good spirits, and his blood pressure and pulse remained steady. The sound of his bones being cut did not upset him. At the beginning, he only felt a scratch on his body but no pain at all when the surgeon was cutting open his scar-covered skin. While cutting his ribs with sure, precise, light and quick strokes, the surgeon gently told him: "Just tell us if you tee\ uncomfortable." "I'm all right," replied Hu, "There's no pain at all. Go ahead." The medical workers cleared out the pus thoroughly, removed the fistula and filled in the cavity. The operation was highly successful. As soon as the surgeon finished dressing the incision, the smiling Hu Shu-hsuan sat up on the operating-table and, facing a portrait of Chairman Mao, cheered: "Long live Chairman Mao! A long, long life to Chairman Mao!"' After each past operation, he had been in a daze for days from the effects of the anaesthetics. His pulse was rapid and breathing was difficult; he had no appetite and slept badly. Several times he almost choked to death because of the phlegm that had accumulated in his throat after the operation. The surgeon had to cut open the trachea and give him oxygen to save his life. Previously, recuperation was slow and it was three weeks after each operation before he could get out of bed and walk. This time, however, anaesthetization by acupuncture made things different. After the operation, he was calm as usual, his breathing was normal and there was little phlegm. He could eat the day the operation was performed, and three days later he could get down from bed and walk about.

II

Tsao Hung-tan. a patient with severe multiple fractures, was wheeled into the operating-room of Chaoyang Hospital in Peking. A reduction of the femoral fracture with anaesthetization by acupuncture was about to begin. A member of the Tsaitun Commune in Miyun County on Peking's outskirts, the patient had been in an accident and sustained fractures in his right upper arm, right thigh and shank, several right ribs and lumbar vertebrae, as well as the pelvis. On arriving at the hospital, he was pale and his limbs cold; his systolic pressure had dropped to 50 mm. H., while his diastolic pressure was indeterminable. He was in a state of severe shock. He came to after emergency treatment, but reduction of the fractures presented a complicated problem. The comminuted fracture in the patient's right thigh called for an incision in order to perform the reduction. But the injury was very serious, and there had been considerable loss of blood. Moreover, he had just come out of shock and was very weak. Four ribs were fractured, and the pain affected his breathing, making it difficult to cough up phlegm. General anaesthesia by drugs could easily cause pulmonary complications and unforeseen danger. The surgeons decided to do the operation with acupunctural anaesthesia. After slowly and carefully inserting two needles into two points on the patient's left ear, the anesthesiologists insetted two other needles into the right ear, and one each on the hip and the abdomen, and connected them with wires to a small electrical apparatus for anaesthetization. When the current was turned on, the patient became numb, heavy and distended in the region where the needles were, as in the case where needles were manipulated by hand. The operation began 20 minutes later. A surgeon cut open the skin on the thigh and the hypodermis and separated the muscles, exposed the fractured femur and reduced the dislocated fractured bones. He then punctured the femur with an electric drill and fixed the fractured bones with a steel plate and screws after which the incision was closed with sutures. Throughout the operation which lasted more than an hour the patient remained calm, and his blood pressure and pulse were normal. Only when the fractured bones were reduced did he feel somewhat uncomfortable because of muscle traction. But this feeling soon disappeared after the frequency of the electric needles was increased and the surgeon told him to breathe deeply and relax his muscles. When he was taken back to the ward after the operation, Tsao Hung-tan could eat and drink without difficulty. While recuperating, he showed no signs of agitation common to patients after operations performed with anaesthesia by drugs, thus preventing possible bad effects on other fractured parts.

III

The health centre of the Lochia Commune in Kiangsi Province's Nanchang County has very simple equipment. Most of its staff are ''barefoot doctors" (medical trainees from among the peasants who do medical and health work in addition to their regular job in production) selected from various production brigades. They mastered anaesthetization by acupuncture after a short period of training. At the end of last year, the doctors there used acupunctural anaesthesia to perform a gastrectomy on 55-year-old poor peasant Wan Ting-li who had a gastric ulcer. A few needles were inserted into the patient's auricles while he lay quietly on the operating-table. A young surgeon, Wan Tao-keng, opened the abdomen and after examining it carefully, found an adhesion of the ulcerous part to the posterior abdominal wall. Together with his assistants, the surgeon carefully separated it, performed the subtotal gastrectomy without a hitch and then joined up the stomach and intestine. During the operation which lasted two hours and 45 minutes, the patient was calm, with normal breathing and pulse. He felt somewhat uncomfortable only during the separation of the duodenal bulb as a result of visceral traction; At that point, the surgeon told him to do deep breathing which immediately made him feel better. After the operation, he put on his clothes, got off the operating-table and walked back to the ward. Nine days later, he left the hospital. After three months of recuperation, he regained his health and was able to take part in transplanting rice seedlings, harvesting and other work. Safe, effective, simple and economical, acupunctural anaesthesia has created extremely favourable conditions for operations in the countryside. The Lochia Commune health centre is now able to use acupunctural anaesthesia by needling the body, ears and nose to perform more than 20 kinds of minor and medium operations, and the rate of success is over 90 per cent.